| NPI | 1972001428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005923RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9111077) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2023-03-07 |