| NPI | 1942219423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50-003036) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002488) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2010-06-09 |