| NPI | 1124624473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006601RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006601) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2024-04-15 |