NPI | 1346344462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50-002918) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 1000496) |
Enumeration Date | 2006-09-11 |
Last Update Date | 2021-01-13 |