| NPI | 1598285751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006046RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006446) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-10-07 |