NPI | 1073051926 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13033) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2017003238) |
Enumeration Date | 2017-02-10 |
Last Update Date | 2020-12-11 |