| NPI | 1942581558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2597) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054783) |
| 363A00000X Physician Assistant (Licence: OH 50.004225) | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2017-02-07 |