| NPI | 1942240460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008181RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA01793) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-09-14 |