| NPI | 1134769458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8921) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2025-06-20 |