NPI | 1578184883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13704) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5544) |
Enumeration Date | 2020-04-28 |
Last Update Date | 2021-09-16 |