NPI | 1184338527 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15446) |
Enumeration Date | 2023-01-10 |
Last Update Date | 2025-09-16 |