| NPI | 1821242850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10728) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01580) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2020-10-09 |