| NPI | 1144680943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007014RX) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT.003944) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2021-08-26 |