| NPI | 1376895201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14464) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 363A00000X Physician Assistant (Licence: IA 111211) | |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2023-05-26 |