NPI | 1104401694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007668) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003491A) |
Enumeration Date | 2021-03-16 |
Last Update Date | 2024-05-09 |