| NPI | 1265636187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10270) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3033) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2024-03-15 |