| NPI | 1649262213 |
|---|---|
| Former Name | PAULA M NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1773-023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005426) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2015-03-04 |