NPI | 1073757605 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50-001647) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61471747) |
Enumeration Date | 2009-04-27 |
Last Update Date | 2023-10-18 |