| NPI | 1922202902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10274) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 988) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-24 |