| NPI | 1245319722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0273) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 9681) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |