| NPI | 1538754197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 115822) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15177) |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2024-12-05 |