| NPI | 1356923601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13852) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5721-23) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-02-12 |