NPI | 1619658242 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14657) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7635) |
Enumeration Date | 2023-07-27 |
Last Update Date | 2024-10-11 |