| NPI | 1417234899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 1914) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1914) |
| 363A00000X Physician Assistant (Licence: MN 11052) | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2023-07-11 |