| NPI | 1861934226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14294) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10891) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2023-07-22 |