NPI | 1538535984 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 712) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004403) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2024-01-03 |