| NPI | 1194000869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0494) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0494) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2023-05-09 |