| NPI | 1699915819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0835) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10669) |
| 363A00000X Physician Assistant (Licence: SD 0712) | |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2022-04-19 |