NPI | 1235101171 |
---|---|
Former Name | JORI L MYERS |
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 | 2013-11-13 |