| NPI | 1245760891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.010186RX) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2026-05-13 |