| NPI | 1255983888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0798) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13188) |
| 363A00000X Physician Assistant (Licence: AK 153229) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2020-01-07 |