| NPI | 1023778305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14398) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 112138) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2023-02-21 |