| NPI | 1316019466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2181) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2017-03-07 |