| NPI | 1467014233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0010-09228) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2021-05-05 |