NPI | 1285938985 |
---|---|
Former Name | BRENNA LYNN JENSEN-STONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1245) |
Enumeration Date | 2011-01-10 |
Last Update Date | 2023-09-19 |