| NPI | 1013335801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 11929) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2024-09-25 |