| NPI | 1720038029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11089) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0203) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-04-29 |