| NPI | 1487438412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.008332RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC186) |
| 363A00000X Physician Assistant (Licence: IN 10004413A) | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2024-07-30 |