| NPI | 1891205746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3468) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 50.005228RX) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-02-23 |