NPI | 1962976324 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15180) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005906RX) |
Enumeration Date | 2019-01-17 |
Last Update Date | 2025-03-12 |