| NPI | 1861156051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030071) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2023-10-25 |