| NPI | 1538727839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR 222552) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13037) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2024-09-25 |