NPI | 1114486453 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61138) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12948) |
Enumeration Date | 2019-03-17 |
Last Update Date | 2022-07-12 |