| NPI | 1609695824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1224938) |
| Enumeration Date | 2024-10-04 |
| Last Update Date | 2024-12-03 |