| NPI | 1083251243 |
|---|---|
| Former Name | JORDAN CUNNINGHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001361) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001361) |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2024-08-23 |