| NPI | 1609213529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0697) |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2022-07-25 |