| NPI | 1407153588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11060) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50-003241) |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2025-01-30 |