NPI | 1699396622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13711) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-04-30 |
Last Update Date | 2021-05-07 |