| NPI | 1063259430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 50.009832RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.009832RX) |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2025-11-23 |