| NPI | 1306205794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004624RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2024-01-31 |