NPI | 1013288166 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005533RX) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: FL PA9106438) | |
363AM0700X Physician Assistant, Medical (Licence: FL PA9106438) | |
Enumeration Date | 2012-01-21 |
Last Update Date | 2020-11-18 |