| NPI | 1124670799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MN 12997) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12997) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-09-16 |