| NPI | 1851900575 |
|---|---|
| Former Name | SAVANNAH ROUGHTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006941RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010575) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2025-02-24 |