NPI | 1609819754 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11028) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004075) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2013-03-26 |