| NPI | 1861976904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13349) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-006752) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2022-01-27 |