| NPI | 1174976971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12180) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2020-10-09 |