| NPI | 1528583846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0723) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12482) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2020-08-14 |