| NPI | 1770546046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9538) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 9538) |
| 363AS0400X Physician Assistant, Surgical (Licence: MN 9538) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2024-05-16 |