| NPI | 1881083053 |
|---|---|
| Former Name | MACKENZI E BUCKHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002225-RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50004146) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2023-01-25 |