NPI | 1528343613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003418RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC224) |
363A00000X Physician Assistant (Licence: KY PA3049) | |
Enumeration Date | 2011-10-20 |
Last Update Date | 2023-10-02 |