| NPI | 1245707942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4185) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.006498RX) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2024-11-11 |