| NPI | 1932874468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007074RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-1151) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2025-04-24 |