| NPI | 1043300205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10324) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA504) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-06-04 |