| NPI | 1700448438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008223) |
| Additional Taxonomies | 208800000X Urology (Licence: OH 50.006717RX) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2024-05-24 |