| NPI | 1225760572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14802) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 1225760572) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2024-02-08 |