NPI | 1720216088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10598) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1080393) |
Enumeration Date | 2009-06-25 |
Last Update Date | 2022-12-06 |