| NPI | 1770551509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50001241) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.001241RX) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-10-10 |