| NPI | 1508421272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009247RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 1003436A) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2025-08-15 |