| NPI | 1235829474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14759) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117726) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-05-15 |