| NPI | 1750094405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008650RX) |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2024-02-19 |