NPI | 1679594915 |
---|---|
Former Name | MELISSA SUE TUSETH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10070) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 10070) |
Enumeration Date | 2006-07-22 |
Last Update Date | 2022-06-14 |