| NPI | 1861121089 |
|---|---|
| Former Name | ASHLEY NICOLE LONGTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14720) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: ND PAC1043) | |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2024-01-08 |