| NPI | 1821739525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 50.007741RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-11-16 |