NPI | 1598251308 |
---|---|
Former Name | HEATHER HORGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12742) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4895) |
Enumeration Date | 2018-07-04 |
Last Update Date | 2024-10-14 |