NPI | 1184616179 |
---|---|
Former Name | JENNIFER L PURDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000730A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.003806) |
Enumeration Date | 2005-08-17 |
Last Update Date | 2022-11-15 |