| NPI | 1902853682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000544A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002290) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2024-05-08 |