| NPI | 1003431990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY 49841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006418RX) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2023-11-17 |