| NPI | 1528673845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA063290) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006637) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2023-02-13 |