NPI | 1508213380 |
---|---|
Former Name | MEGAN ERICKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0652) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12309) |
Enumeration Date | 2016-05-20 |
Last Update Date | 2019-10-07 |