| NPI | 1750503611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11549) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1421) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2024-12-19 |