NPI | 1265626055 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10329) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1035) |
Enumeration Date | 2007-09-05 |
Last Update Date | 2020-10-09 |