| NPI | 1669985362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14992) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 50.005282RX) |
| 363AM0700X Physician Assistant, Medical (Licence: OH 50.005282RX) | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2025-01-30 |