| NPI | 1558393157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9510) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4565-23) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-05-03 |