NPI | 1013206978 |
---|---|
Former Name | JENNIFER LYNN SASSANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014686) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 14686) |
Enumeration Date | 2011-03-31 |
Last Update Date | 2023-07-06 |