| NPI | 1285110981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002544A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005495RX) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-04-10 |