| NPI | 1043760820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 12870) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058619) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2020-02-10 |