NPI | 1053778191 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12112) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53956) |
Enumeration Date | 2016-01-20 |
Last Update Date | 2024-10-28 |