| NPI | 1699059410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11346) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2858-33) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2019-05-07 |