| NPI | 1285293894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008805RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060666) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2024-08-19 |