NPI | 1275285439 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC MPA.4924) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007389) |
Enumeration Date | 2022-01-19 |
Last Update Date | 2023-11-02 |