| NPI | 1548733579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12892) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2023-10-04 |