NPI | 1760059075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5450) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14442) |
Enumeration Date | 2021-06-06 |
Last Update Date | 2024-02-14 |