| NPI | 1609849744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12455) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6831) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-24 |