| NPI | 1346979580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0935) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14032) |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2022-10-05 |