| NPI | 1407367261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13062) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059450) |
| 363AM0700X Physician Assistant, Medical (Licence: MN 13062) | |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2024-04-02 |