NPI | 1083043616 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.003913) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-11-04 |
Last Update Date | 2018-08-22 |