| NPI | 1043451529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10896) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 20221) |
| 363A00000X Physician Assistant (Licence: MN 1533) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2018-06-29 |