| NPI | 1588031355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005022RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10001898A) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2021-07-26 |