| NPI | 1144299199 |
|---|---|
| Former Name | JENNIFER SIMMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085002081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001518) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |