| NPI | 1326647652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13594) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0006463) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2026-03-16 |