| NPI | 1710549787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007547RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9112256) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2022-07-11 |