| NPI | 1538131883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10431) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2005032623) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2008-10-28 |