| NPI | 1023739331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14139) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-1300) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2025-05-01 |