| NPI | 1285101329 |
|---|---|
| Former Name | JORDAN M EVANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1687) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6843) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA 6843) | |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2024-05-09 |