| NPI | 1225392202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2466) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1790) |
| 363A00000X Physician Assistant (Licence: MN 11158) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2017-05-22 |