| NPI | 1639889868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007843RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 1199527) |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2025-10-20 |