| NPI | 1255723508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007114RX) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH 7318) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2022-02-06 |