| NPI | 1730367939 |
|---|---|
| Former Name | TAMRA J JACOBSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 2150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0664) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2024-11-12 |