| NPI | 1609384544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13740) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55277) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2023-09-07 |