| NPI | 1720216088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10598) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1080393) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-12-06 |