NPI | 1629596044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005218RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005218RX) |
Enumeration Date | 2017-09-06 |
Last Update Date | 2021-01-25 |