| NPI | 1184027732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004123Rx) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001006685) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2021-01-26 |