| NPI | 1932139839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003160A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002298RX) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2021-05-17 |