| NPI | 1033128103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10226) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003334) |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2016-05-13 |