| NPI | 1285322974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14587) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 14587) |
| 363A00000X Physician Assistant (Licence: WI 7510) | |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-09-21 |