| NPI | 1023608908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0928) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11969) |
| 363A00000X Physician Assistant (Licence: TN 4932) | |
| 363A00000X Physician Assistant (Licence: AK 191361) | |
| 363A00000X Physician Assistant (Licence: MN 13973) | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2023-10-18 |