NPI | 1871179234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14138) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7052) |
Enumeration Date | 2021-03-24 |
Last Update Date | 2024-04-05 |