NPI | 1164441630 |
---|---|
Former Name | JENNIFER KIEFFER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051311) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 9488) |
363AM0700X Physician Assistant, Medical (Licence: NY 09488-1) | |
Enumeration Date | 2006-07-18 |
Last Update Date | 2023-07-05 |