| NPI | 1437525417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3571-23) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2018-04-30 |