| NPI | 1902021975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002363RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002363) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-25 |