| NPI | 1316499171 |
|---|---|
| Former Name | KIRSTEN JACOBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0006057) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 50.004801) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2022-11-09 |