| NPI | 1437856812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 319906) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008046) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2024-10-09 |