| NPI | 1740951227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14746) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA16298) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2024-02-14 |