| NPI | 1598543282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14755) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5601011898) |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2024-02-21 |