| NPI | 1790041226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OH 50.006203) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2024-09-11 |