| NPI | 1063119873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009485RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA064358) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA OA006388) | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2025-08-19 |