NPI | 1417438151 |
---|---|
Former Name | ERIN LEISEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14857) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-08-21 |
Last Update Date | 2024-04-10 |