| NPI | 1619590338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006960RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2023-03-27 |