| NPI | 1093336539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008774RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026417) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-10-17 |