| NPI | 1033757554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007429RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4262) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2024-02-29 |