| NPI | 1801047170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002114) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10492) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2016-03-22 |