NPI | 1760951610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006262RX) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 023002) |
Enumeration Date | 2018-11-21 |
Last Update Date | 2022-02-28 |