| NPI | 1356141600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC1170) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15451) |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-08-20 |