| NPI | 1932188877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11727) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1320) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2025-11-17 |