| NPI | 1982172268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01314) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005743RX) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2023-06-14 |