NPI | 1275183063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13171) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 14007974-1206) |
Enumeration Date | 2019-09-13 |
Last Update Date | 2025-08-04 |