| NPI | 1407683998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.009295RX) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2025-11-03 |