| NPI | 1538744065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006762RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062279) |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2022-12-14 |