| NPI | 1366833907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11799) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2023-09-05 |