| NPI | 1982118378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007901RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07438) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2023-01-10 |