| NPI | 1053086702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008086RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA Ma062760) |
| Enumeration Date | 2021-08-14 |
| Last Update Date | 2023-08-22 |