| NPI | 1194550657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA066524) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008864RX) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2025-05-09 |