| NPI | 1770259483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.007823RX) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 50.007823RX) |
| 363A00000X Physician Assistant (Licence: OH 50.007823RX) | |
| Enumeration Date | 2021-08-22 |
| Last Update Date | 2024-08-15 |