| NPI | 1053938134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006478RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061723) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2024-08-26 |