| NPI | 1487077434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13585) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004469) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2021-07-21 |