| NPI | 1922103902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002277) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 454731) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |