| NPI | 1740908524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5817) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007697RX) |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2024-06-17 |