NPI | 1174707632 |
---|---|
Former Name | JOVIANE DESJARDINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00511800) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012267) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2019-05-23 |