| NPI | 1578705059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-106896) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1266) |
| 363A00000X Physician Assistant (Licence: MN 10582) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2024-02-19 |