| NPI | 1033115480 |
|---|---|
| Former Name | JAMIE LYNN SWANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2024-04-03 |