NPI | 1265698658 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005373RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2324-023) |
Enumeration Date | 2008-08-05 |
Last Update Date | 2025-04-25 |