| NPI | 1851874416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12767) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0872) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2022-09-27 |