| NPI | 1720434798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12127) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MN 12127) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2019-06-21 |