| NPI | 1972012482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 153300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13162) |
| 363A00000X Physician Assistant (Licence: UT 11674343-1206) | |
| 363A00000X Physician Assistant (Licence: ND PAC0801) | |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2023-05-23 |