| NPI | 1881121069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006090RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 6754) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2019-11-04 |