| NPI | 1528552395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007816RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: SC 3997) | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2023-01-13 |