| NPI | 1316022452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14737) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50001873) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-12-06 |