| NPI | 1013273143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 101525) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5783) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2022-02-01 |