| NPI | 1376976639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11446) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1993) |
| 363A00000X Physician Assistant (Licence: IL 085.004763) | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2024-06-11 |