NPI | 1043566169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59475) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 11204) |
Enumeration Date | 2012-07-26 |
Last Update Date | 2021-08-09 |