NPI | 1629588140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005314RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH APP-000115605) |
Enumeration Date | 2017-10-10 |
Last Update Date | 2023-10-26 |