| NPI | 1669104915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7842-23) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2024-06-21 |