| NPI | 1568120756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13977) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 13977) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-12-04 |
| Last Update Date | 2024-06-24 |