| NPI | 1457132870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065336) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.009628RX) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2025-09-03 |