| NPI | 1073051926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13033) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2017003238) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2020-12-11 |