| NPI | 1265152367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14910) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7027-23) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2024-08-22 |