NPI | 1003849837 |
---|---|
Former Name | JENTRY DANIELLE ANDREWS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA05748) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ MP00154600) |
363A00000X Physician Assistant (Licence: TX PA05748) | |
Enumeration Date | 2006-07-07 |
Last Update Date | 2009-06-15 |