| NPI | 1730890369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 31-6000064) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2024-08-01 |