| NPI | 1285288431 |
|---|---|
| Former Name | KAITLYN JENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5741) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031616) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2022-02-09 |