| NPI | 1215376124 |
|---|---|
| Former Name | JENNIFER LAUREN HAMILTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C05068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5163) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2022-01-06 |