| NPI | 1114671765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007057RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.0007057) |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-03-01 |