| NPI | 1750713608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11373) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1925) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2020-08-21 |