| NPI | 1972906154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007303RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 51975) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10002069A) | |
| 363AM0700X Physician Assistant, Medical (Licence: MI 5601009235) | |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2022-09-13 |