| NPI | 1659761898 |
|---|---|
| Former Name | KOURTNY WEDEKING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11808) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2024-05-06 |