| NPI | 1477071447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 2102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12523) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2023-12-07 |