| NPI | 1336483429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11280) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1841) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2020-08-21 |