| NPI | 1932420791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC056) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2021-09-17 |