| NPI | 1023507001 |
|---|---|
| Former Name | SARAH GRACE BUSCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005462RX) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 50.005462RX) |
| Enumeration Date | 2018-05-06 |
| Last Update Date | 2020-10-31 |