| NPI | 1184941411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3097) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10712) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2022-04-04 |