| NPI | 1275843419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3640) |
| 363A00000X Physician Assistant (Licence: UT 7798782-1206) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2023-01-09 |