| NPI | 1245864941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA217640) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13448) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2023-11-14 |