| NPI | 1659706224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004630RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA MA056438) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2023-03-07 |