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 | 2025-01-22 |