| NPI | 1144474917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10530) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 1221) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2019-08-23 |