NPI | 1891415782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH APP-000736296) |
Enumeration Date | 2022-08-31 |
Last Update Date | 2024-04-20 |