| NPI | 1043960123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14014) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 8913-23) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2026-06-02 |