NPI | 1942581558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2597) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054783) |
363A00000X Physician Assistant (Licence: OH 50.004225) | |
Enumeration Date | 2011-09-09 |
Last Update Date | 2017-02-07 |