NPI | 1649424078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 10460) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10460) |
Enumeration Date | 2008-11-12 |
Last Update Date | 2017-11-29 |