NPI | 1023358751 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004965RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL B640536866330) |
Enumeration Date | 2013-02-16 |
Last Update Date | 2019-06-13 |