| NPI | 1427605732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006103RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.006103) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2021-05-18 |