| NPI | 1649641523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004865RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06031) |
| Enumeration Date | 2015-10-17 |
| Last Update Date | 2022-04-28 |