| NPI | 1922243567 |
|---|---|
| Former Name | DESIREE RETTIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002884RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 50.002884) |
| 363AM0700X Physician Assistant Medical (Licence: NY 027393) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2024-06-10 |