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1013685098
EBTISAM WAIS
SAINT PAUL, MN
NPI
1013685098
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 14700)
Enumeration Date
2021-09-02
Last Update Date
2024-04-04
Business Address
EBTISAM WAIS
640 JACKSON ST
SAINT PAUL, MN 55101-2502
Phone number: 651-254-3456
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Mailing Address
EBTISAM WAIS
640 JACKSON ST
SAINT PAUL, MN 55101-2502
Phone number:
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