| NPI | 1154946911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008860RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061540) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2026-04-09 |