| NPI | 1952641987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0738) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106926) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2018-09-14 |