NPI | 1285303560 |
---|---|
Former Name | MEGAN JO ERICKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14427) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-09-09 |
Last Update Date | 2023-04-25 |