| NPI | 1750759189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006981RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003586) |
| 363AM0700X Physician Assistant, Medical (Licence: OH 50.006981RX) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA057713) | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2025-01-27 |