| NPI | 1740901370 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009583RX) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003695A) | 
| Enumeration Date | 2022-09-12 | 
| Last Update Date | 2025-09-12 |