| NPI | 1477802189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1800) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2021-02-16 |