| NPI | 1538310990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 1209) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 10512) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2022-01-30 |