| NPI | 1740687128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0840) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001210) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2024-06-25 |