| NPI | 1578805602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003759RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003759) |
| 363AM0700X Physician Assistant, Medical (Licence: OH 50.003759RX) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2022-07-15 |