| NPI | 1205450087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007059rx) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA061580) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2024-04-17 |