| NPI | 1659986263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14288) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AK 188935) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2023-08-02 |