NPI | 1407246135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10636633-1206) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004282RX) |
363AS0400X Physician Assistant, Surgical (Licence: OH 50.004282) | |
Enumeration Date | 2015-02-03 |
Last Update Date | 2019-03-07 |