| NPI | 1548794530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14920) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020763) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-12-27 |