| NPI | 1316456262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12574) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2023-10-02 |