| NPI | 1265869655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107482) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2020-04-22 |