| NPI | 1821455080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.004560RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004560RX) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2019-04-18 |