| NPI | 1083323190 |
|---|---|
| Former Name | EMILY NICOLE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14273) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 14273) |
| 363AM0700X Physician Assistant, Medical (Licence: MN 14273) | |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2023-06-09 |