| NPI | 1124799093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7820) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2024-09-17 |