NPI | 1073006672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 14341) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008251) |
363A00000X Physician Assistant (Licence: MN 14341) | |
Enumeration Date | 2018-06-08 |
Last Update Date | 2024-06-19 |