| NPI | 1154419596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0136) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0136) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-04-24 |