| NPI | 1447623723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007546RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057854) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2023-02-15 |