NPI | 1801180211 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004685RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 6101) |
Enumeration Date | 2011-06-02 |
Last Update Date | 2018-06-26 |