| NPI | 1578144887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1166370) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-06-10 |