NPI | 1265405252 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 8843) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 363A00000X) |
Enumeration Date | 2006-02-09 |
Last Update Date | 2012-07-13 |