| NPI | 1891289518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006423RX) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006423RX) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2023-10-17 |