| NPI | 1023748068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN PENDING) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-10-16 |