| NPI | 1629751490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004930A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008304RX) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2025-09-04 |