NPI | 1861888620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12170) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 12170) |
Enumeration Date | 2015-04-08 |
Last Update Date | 2023-04-13 |