| NPI | 1760668180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 1071818) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2019-01-17 |