| NPI | 1497059273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15360) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54208) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9114297) | |
| 363A00000X Physician Assistant (Licence: FL PA9114297) | |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2025-10-09 |