| NPI | 1407415201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5070) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2023-11-06 |