| NPI | 1295195600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12230) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3724) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2017-07-24 |