| NPI | 1487321295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007847RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 50.007547RX) |
| Enumeration Date | 2021-08-28 |
| Last Update Date | 2024-10-08 |