NPI | 1053086702 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008086RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA Ma062760) |
Enumeration Date | 2021-08-14 |
Last Update Date | 2023-08-22 |