| NPI | 1023879335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008611RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 50.008611RX) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-09-02 |