| NPI | 1750856118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008503) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005630RX) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2022-08-21 |