| NPI | 1760260566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008372RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC010) |
| 363A00000X Physician Assistant (Licence: IN 10004715A) | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2025-02-06 |