| NPI | 1134866171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008652RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5024) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2024-07-14 |