| NPI | 1811656812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008152RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2025-10-20 |