| NPI | 1962976324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 15180) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005906RX) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2025-03-12 |