| NPI | 1831660067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14107) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07230) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2022-07-27 |