| NPI | 1932126893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: ND PAC0286) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MN 9818) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2012-10-16 |