| NPI | 1457504094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12932) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 103655) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-08-24 |