| NPI | 1497756100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006590RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3724) |
| 363A00000X Physician Assistant (Licence: OH 50.006590) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2025-01-15 |