| NPI | 1437615853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12571) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2020-12-22 |