| NPI | 1386295954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085012093) |
| 363A00000X Physician Assistant (Licence: CO PA.0009681) | |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2026-02-12 |