NPI | 1255872115 |
---|---|
Former Name | CAROLINE LEE OLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12711) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-03-12 |
Last Update Date | 2024-07-22 |