| NPI | 1891462032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-15466) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2026-06-11 |