| NPI | 1972541373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1660-023) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-08-24 |