| NPI | 1306812235 |
|---|---|
| Former Name | JEANNE KNUDSVIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006165) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08589) |
| 363AM0700X Physician Assistant Medical (Licence: PA04936) | |
| 363AM0700X Physician Assistant Medical (Licence: NH 0472P) | |
| 363AM0700X Physician Assistant Medical (Licence: WA PA60698597) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2024-06-20 |