NPI | 1376979252 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13962) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 3277) |
Enumeration Date | 2013-09-23 |
Last Update Date | 2022-02-17 |