| NPI | 1144979626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.008549RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 5647) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2024-02-27 |