NPI | 1720065956 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0003814) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002134) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2022-07-21 |