| NPI | 1437182573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0601) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10068) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-12-02 |