| NPI | 1043854409 |
|---|---|
| Former Name | JACKIE REUTHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002853A) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2023-08-22 |