| NPI | 1881225837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1381) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MN 13707) | |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2024-01-15 |