| NPI | 1356069785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007766RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: WV 2667) | |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-12-14 |