| NPI | 1972895803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ND PAC0549) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SD 0779) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2014-12-26 |