| NPI | 1912560384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14279) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07580) |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2024-05-28 |