NPI | 1336790021 |
---|---|
Former Name | HALEY ANN JACOBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007374) |
Enumeration Date | 2019-09-24 |
Last Update Date | 2024-10-02 |