| NPI | 1659770147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12886) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 1077184) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2024-07-08 |