| NPI | 1104459825 |
|---|---|
| Former Name | JENNIFER JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00849500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-007356) |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2026-06-01 |