| NPI | 1598293565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005140RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2019-09-10 |