NPI | 1669104915 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14851) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7842-23) |
Enumeration Date | 2022-06-27 |
Last Update Date | 2024-06-21 |