NPI | 1164479879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 5002265) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002265) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2018-06-28 |