| NPI | 1821106485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0306) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 1972) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-12-28 |