| NPI | 1972198356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13999) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5503) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2022-06-06 |