| NPI | 1710455084 |
|---|---|
| Former Name | CAITLIN MATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4593-23) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2023-04-04 |