| NPI | 1619280625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11278) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002117) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2023-03-28 |