NPI | 1275540064 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50-002472) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001135A) |
Enumeration Date | 2006-08-02 |
Last Update Date | 2019-08-27 |