| NPI | 1770816225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10903) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002025) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2018-12-10 |