| NPI | 1851524144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11137) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4461) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2012-12-18 |