| NPI | 1700457249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 1169835) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13763) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2021-08-02 |