| NPI | 1427413590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52997) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2025-12-05 |