| NPI | 1033687389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001474) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005795RX) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2022-12-19 |