| NPI | 1912370545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50005372RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC441) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2018-01-08 |