| NPI | 1861024945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13265) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4967) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2024-02-01 |