| NPI | 1235101171 |
|---|---|
| Former Name | JORI L EIDEM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9884) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1967-023) |
| Enumeration Date | 2006-02-04 |
| Last Update Date | 2026-06-09 |