| NPI | 1760083059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15310) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14006) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2025-11-17 |