| NPI | 1497399901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14140) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085007336) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085007336) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MN 14140) | |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2023-05-25 |