| NPI | 1518923994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0232) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 9504) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2017-01-23 |