| NPI | 1336255975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10688) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 579) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2010-04-15 |