| NPI | 1831618776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6885) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2020-08-21 |