| NPI | 1073084463 |
|---|---|
| Former Name | COURTNEY MARIE DOCKTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12927) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 12927) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2022-08-12 |