| NPI | 1326776642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15663) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2024-0151) |
| Enumeration Date | 2022-08-13 |
| Last Update Date | 2026-04-21 |