| NPI | 1982167326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008533RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113639) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-02-05 |