| NPI | 1730840695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.00733RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004861A) |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2025-06-23 |