| NPI | 1629664214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006777RX) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2025-05-07 |