NPI | 1578175519 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.007638RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007638RX) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-08-20 |
Last Update Date | 2024-01-22 |