| NPI | 1265789234 |
|---|---|
| Former Name | JENNIFER J MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 3024) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3024) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2022-05-25 |