| NPI | 1427338300 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11013) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1611) | 
| Enumeration Date | 2011-08-23 | 
| Last Update Date | 2020-08-24 |