| NPI | 1841868130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062436) |
| 363A00000X Physician Assistant (Licence: PA OA005616) | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2022-11-01 |