NPI | 1942671201 |
---|---|
Former Name | KAITLYN DON PROULX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 2348) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7142) |
Enumeration Date | 2015-10-13 |
Last Update Date | 2022-12-21 |