| NPI | 1700341260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13770) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006598) |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2021-08-13 |