| NPI | 1043419450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10296) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0370) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2011-08-02 |