| NPI | 1265469647 |
|---|---|
| Former Name | JENNIFER HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13825) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2709) |
| 363AS0400X Physician Assistant, Surgical (Licence: IA 001726) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-07-13 |