| NPI | 1215447602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005302RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.005302RX) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2022-01-25 |