| NPI | 1164972477 |
|---|---|
| Former Name | JENNIFER RACHEL FARREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7508) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 1210) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2020-09-10 |