| NPI | 1457997132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006016RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006016RX) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2022-09-11 |