NPI | 1336483429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11280) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1841) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2020-08-21 |