| NPI | 1942078837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008712RX) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-04-16 |