| NPI | 1952064610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 1187268) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007254RX) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: 1187268) | |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2024-03-19 |