| NPI | 1275183063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13171) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 14007974-1206) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2026-06-02 |