| NPI | 1750614582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 2068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003560) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2014-07-16 |