| NPI | 1134685373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 99423) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0766) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2021-06-17 |