| NPI | 1407821440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9743) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1513-23) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2025-09-05 |