| NPI | 1710173000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.003248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066458) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2025-04-04 |