| NPI | 1689027500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: OH 50.004733RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2019-07-12 |