| NPI | 1932619954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14651) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005158) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2023-12-13 |