NPI | 1023255387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002806) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002806) |
363AM0700X Physician Assistant, Medical (Licence: OH 54.000538) | |
363A00000X Physician Assistant (Licence: OH 55.000538) | |
Enumeration Date | 2009-01-08 |
Last Update Date | 2015-06-18 |