| NPI | 1831548825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12073) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1733) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2018-04-05 |