| NPI | 1184358566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12815) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007530RX) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2025-01-10 |