| NPI | 1417306242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14508) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53489) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2023-10-02 |