| NPI | 1407084270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002019) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2023-01-12 |