NPI | 1417432683 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 12800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12800) |
Enumeration Date | 2018-10-03 |
Last Update Date | 2024-10-06 |