| NPI | 1881894624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 14078) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2134-23) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2023-08-18 |