| NPI | 1124667787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006141RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005146) |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2023-12-15 |