| NPI | 1235130428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 11267) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10000455A) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2013-01-28 |