| NPI | 1316278187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11213) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012434-1) |
| 363A00000X Physician Assistant (Licence: MN 1782) | |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2018-03-09 |