| NPI | 1043846520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007890RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062236) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2023-06-07 |