| NPI | 1639220080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10360) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 3553) |
| 363AM0700X Physician Assistant, Medical (Licence: MN 10360) | |
| 363AM0700X Physician Assistant, Medical (Licence: WI 2553-23) | |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2025-03-19 |