| NPI | 1891068383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003282) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2015-06-08 |