| NPI | 1881914877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 10769) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 1410) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2020-09-28 |