| NPI | 1154717866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004275RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007576) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-09-18 |