| NPI | 1245604529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005647RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003653) |
| 363A00000X Physician Assistant (Licence: PA MA057921) | |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2022-05-10 |