| NPI | 1215333836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11707) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 2166) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2020-10-09 |