| NPI | 1538278791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9172) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1318) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2009-03-19 |