| NPI | 1720447790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12123) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2474) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2021-01-19 |