| NPI | 1538573811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 11571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 2086) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2020-09-17 |