NPI | 1255790382 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12099) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2016-02-17 |
Last Update Date | 2020-08-24 |