| NPI | 1437707957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13164) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5065-23) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2026-01-21 |