| NPI | 1134899081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007180RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 1167488) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2024-04-02 |