Individual
MS. IVY ELIZABETH POMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085007062
IL
363A00000X
Physician Assistant
Primary
50.003660RX
OH
Other
Enumeration date
09/17/2012
Last updated
10/31/2019
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