NPI | 1043612609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0726) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA0004002) |
Enumeration Date | 2014-09-25 |
Last Update Date | 2024-06-04 |