| NPI | 1780120980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13412) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0672) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2024-10-30 |