NPI | 1023778305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14398) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 112138) |
363A00000X Physician Assistant | |
Enumeration Date | 2021-12-28 |
Last Update Date | 2023-02-21 |