| NPI | 1649792227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005154RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006680) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2023-05-16 |