| NPI | 1942849948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13306) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 8386) |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2025-05-27 |