| NPI | 1508578618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.009577RX) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 4706) |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2025-10-13 |