| NPI | 1942461702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002248RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 2248) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-12-03 |