| NPI | 1871179234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7052) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-04-05 |