NPI | 1750665576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 10996) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 1630) |
Enumeration Date | 2011-09-29 |
Last Update Date | 2020-09-18 |