NPI | 1760260566 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.008372RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC010) |
363A00000X Physician Assistant (Licence: IN 10004715A) | |
Enumeration Date | 2023-09-21 |
Last Update Date | 2025-02-06 |