| NPI | 1982933560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10976) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA17447) |
| 207Q00000X Family Medicine (Licence: NM PA2022-0087) | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2025-10-15 |