| NPI | 1760119598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009665RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063472) |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2025-08-27 |