| NPI | 1154724201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003829) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 50.003829RX) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2025-09-16 |