NPI | 1356126338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15170) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC071) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2023-08-29 |
Last Update Date | 2024-12-03 |