| NPI | 1942890900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008462RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10829) |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2024-11-06 |