| NPI | 1881980415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0460) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 10916) |
| 363AM0700X Physician Assistant, Medical (Licence: ND PAC0460) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2024-10-29 |