| NPI | 1245276930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11982) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0332) |
| 363A00000X Physician Assistant (Licence: MN 2338) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-09-18 |