| NPI | 1033791900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 117590) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006595RX) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2023-01-17 |