| NPI | 1013182690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2391) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2024-10-28 |