| NPI | 1144636838 |
|---|---|
| Former Name | ALLIE RAE JAGIELO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11649) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59272) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-12-16 |