| NPI | 1639324023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 10997) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10997) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2021-03-29 |