| NPI | 1760852586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13679) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004415) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2024-01-10 |