NPI | 1619056793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006525RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 00906) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2020-08-28 |