NPI | 1124522438 |
---|---|
Former Name | JACQUELINE A. FISHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13370) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 089709) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2020-06-24 |