NPI | 1912479528 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005550RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08891) |
Enumeration Date | 2018-12-20 |
Last Update Date | 2021-05-18 |