| NPI | 1063733772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MN 10795) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 1445) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2024-02-02 |