| NPI | 1982072393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50006279RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 50006279RX) | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2022-08-02 |