| NPI | 1821276148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10388) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2022-05-19 |