NPI | 1316348170 |
---|---|
Former Name | LAUREN HIMPELMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11884) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2014032114) |
Enumeration Date | 2014-09-11 |
Last Update Date | 2020-08-24 |