NPI | 1215599196 |
---|---|
Former Name | AMY ELIZABETH CLEMENTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006241RX) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-07-01 |
Last Update Date | 2019-11-04 |