| NPI | 1215700307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC1147) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14588) |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2025-05-16 |