| NPI | 1811750680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009355RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 5238) |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2025-03-27 |