| NPI | 1326716598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14686) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 14686) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-04-22 |