| NPI | 1306996780 |
|---|---|
| Former Name | JENNIFER LYNN CASERTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA05397) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001863) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 4948) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2017-04-27 |