| NPI | 1629246293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002683RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WV 01334) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2024-01-09 |