| NPI | 1962513697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006432RX) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-04-05 |