| NPI | 1093069460 |
|---|---|
| Former Name | JENNIFER ROSE WATKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07539) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017656) |
| 363A00000X Physician Assistant (Licence: FL PA9106854) | |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2021-01-25 |