| NPI | 1164678660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0398) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MN 10899) |
| 363AS0400X Physician Assistant Surgical (Licence: ND PAC0398) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2024-09-03 |