| NPI | 1992147797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 11364) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 11364) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2020-06-25 |