| NPI | 1982621454 |
|---|---|
| Former Name | VICKI L PAULSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND 0224) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 5243) |
| 363A00000X Physician Assistant (Licence: MN 9326) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-08-20 |