| NPI | 1326633876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14890) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 174025) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2024-09-16 |