| NPI | 1891274288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006059RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA060092) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2020-02-10 |