| NPI | 1326373317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10660) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2020-01-07 |