NPI | 1467741470 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005423RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02838) |
363AM0700X Physician Assistant, Medical (Licence: NC 001002838) | |
363AS0400X Physician Assistant, Surgical (Licence: OH 50.005423RX) | |
Enumeration Date | 2011-03-30 |
Last Update Date | 2018-05-17 |