| NPI | 1184338527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15446) |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2025-09-16 |