| NPI | 1881110799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OH 50.005071RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: OH 50.005071RX) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-10-17 |