| NPI | 1043786577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005924RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6804) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2022-12-13 |