NPI | 1518288299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0434) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2010-06-17 |
Last Update Date | 2017-12-08 |