| NPI | 1962943092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12375) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2020-10-09 |