| NPI | 1407156326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10850) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1499) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2020-08-24 |