| NPI | 1831646504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA222731) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004839RX) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2024-12-10 |