| NPI | 1144497736 |
|---|---|
| Former Name | JENNIFER MARIE MULLIS GRANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA212952) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005270) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2025-08-05 |