| NPI | 1801961917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000976A) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2023-09-18 |