| NPI | 1386233815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5388) |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2024-03-15 |