NPI | 1013273143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 101525) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5783) |
Enumeration Date | 2012-04-03 |
Last Update Date | 2022-02-01 |