| NPI | 1972914521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004058RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 004058) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2021-12-27 |