| NPI | 1982218616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007656RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003342A) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2023-11-03 |