NPI | 1346725587 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060202) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005979RX) |
Enumeration Date | 2018-10-02 |
Last Update Date | 2022-09-09 |