NPI | 1114901717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12262) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 2261) |
Enumeration Date | 2005-12-06 |
Last Update Date | 2020-08-24 |