| NPI | 1194580670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008514RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-14274) |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2026-04-20 |