| NPI | 1275159840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8710) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006526RX) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2024-07-03 |