| NPI | 1457933921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14939) |
| Enumeration Date | 2021-04-24 |
| Last Update Date | 2024-09-11 |