NPI | 1073904496 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 11800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 2212) |
Enumeration Date | 2015-02-06 |
Last Update Date | 2021-03-02 |