| NPI | 1831293380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11055) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: 1063265) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-11-19 |