| NPI | 1740790377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004303) |
| 363A00000X Physician Assistant (Licence: PA MA059427) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2020-07-14 |