| NPI | 1720738438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007548RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA61007) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2023-10-16 |