| NPI | 1720075666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0387) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0493) |
| 363A00000X Physician Assistant (Licence: MN 9723) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2008-04-02 |