| NPI | 1922556653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005655Rx) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 50.005655rx) |
| 363A00000X Physician Assistant (Licence: FL 9109958) | |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2021-04-19 |