| NPI | 1952782765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11842) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 2275) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2025-04-24 |