| NPI | 1134598196 |
|---|---|
| Former Name | JENNY IN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13247) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1660) |
| 363A00000X Physician Assistant (Licence: TX PA11170) | |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2024-08-09 |