| NPI | 1306296058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006215) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH LD-8008) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2019-10-18 |