| NPI | 1720578958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7873-23) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2025-10-07 |