| NPI | 1326456963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY ROSHAU Office Manager 701-456-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0565) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |