| NPI | 1720700834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007541) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3047) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2023-08-17 |