| NPI | 1194448779 |
|---|---|
| Former Name | JENNIFER E SWANSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14681) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NE 2180) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2024-04-17 |