| NPI | 1437280690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11867) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 1154) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2015-11-25 |