NPI | 1730678178 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007685RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000003400) |
363AS0400X Physician Assistant, Surgical (Licence: TN 3400) | |
Enumeration Date | 2018-05-01 |
Last Update Date | 2022-10-25 |