NPI | 1114517521 |
---|---|
Former Name | JENNIFER RODRIGUEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114103) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-01-20 |
Last Update Date | 2023-05-15 |