| NPI | 1215948781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10142) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4215) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-12-16 |