| NPI | 1477196798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9122094) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007369RX) |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2026-08-17 |