| NPI | 1740623065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0861) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2024-03-16 |