| NPI | 1710777610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009716RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.009716RX) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-09-09 |