| NPI | 1558099929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009369RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14239) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2025-10-02 |