| NPI | 1053857557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005818RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058725) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2021-10-29 |