NPI | 1104419068 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006661RX) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 50.006661RX) |
Enumeration Date | 2021-02-11 |
Last Update Date | 2022-11-03 |