| NPI | 1386032696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005654RX) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2023-12-08 |