| NPI | 1073020798 |
|---|---|
| Former Name | JENNIFER LEE SELF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17651) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063567) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2024-02-21 |