| NPI | 1982796835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0974) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002504) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-12-05 |