NPI | 1912547035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006288RX) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.006288) |
Enumeration Date | 2020-01-07 |
Last Update Date | 2022-02-24 |