NPI | 1487321295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007847RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.007547RX) |
Enumeration Date | 2021-08-28 |
Last Update Date | 2024-10-08 |