| NPI | 1912375452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008768RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52786) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2024-08-14 |