| NPI | 1427029131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11009) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002502) |
| 363AM0700X Physician Assistant, Medical (Licence: MN 11009) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MN 11009) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2022-01-04 |