| NPI | 1447204383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11074) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001268) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-12-02 |