| NPI | 1376617167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.000720RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.000720RX) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2021-11-08 |