| NPI | 1861744732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003597RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE CS-0011506) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2022-12-09 |