| NPI | 1801189931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0464) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002198) |
| 363A00000X Physician Assistant (Licence: DC PA031650) | |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2022-08-12 |