| NPI | 1205858867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT 27751) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0294) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2019-02-21 |