| NPI | 1295469773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007660RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC297) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-02-13 |