| NPI | 1770155517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9118514) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006994RX) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2024-10-11 |