| NPI | 1922192350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.001303RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17447) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-24 |