| NPI | 1467425272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15172) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0558) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2025-08-29 |