| NPI | 1992472260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007026RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 1177136) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2023-10-30 |