| NPI | 1750917985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13453) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MN 13453) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2025-05-01 |