| NPI | 1285791467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.001597RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 50.001597) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2022-05-05 |