| NPI | 1891161196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL 1394) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004171) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2022-10-12 |