| NPI | 1184159295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004979RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3267) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2022-08-31 |