| NPI | 1649000308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15120) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 15120) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-12-30 |