| NPI | 1043067150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15560) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC1192) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2026-01-15 |