| NPI | 1184720666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0155) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1402) |
| 363A00000X Physician Assistant (Licence: MN 10736) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2015-10-20 |