NPI | 1598005753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005345RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006617) |
Enumeration Date | 2013-02-26 |
Last Update Date | 2020-02-21 |