NPI | 1427000124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9464) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 9464) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2017-03-07 |