NPI | 1912415035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005412RX) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-01-11 |
Last Update Date | 2024-01-24 |