| NPI | 1760993018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005294RX) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 50.005294RX) |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: OH 50.005294RX) | |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2020-10-31 |