| NPI | 1184889669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1153) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2020-08-21 |