| NPI | 1518469774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005496RX) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 50.005496RX) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-21 |