| NPI | 1467946699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006073RX) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2020-09-12 |