| NPI | 1679002844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008735RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601008244) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2024-08-27 |