NPI | 1669893160 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004398) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 2446) |
Enumeration Date | 2013-12-30 |
Last Update Date | 2018-11-26 |