NPI | 1699701672 |
---|---|
Former Name | SARAH TERESA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 10018) |
Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN 10018) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2007-10-11 |