| NPI | 1275646978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-006084) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2017-12-28 |