NPI | 1124278593 |
---|---|
Former Name | JENNIFER WEGINER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 1082489) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001931) |
Enumeration Date | 2008-09-23 |
Last Update Date | 2018-05-08 |