| NPI | 1265626055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10329) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1035) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2020-10-09 |