| NPI | 1356475776 |
|---|---|
| Former Name | JEANNE MOYNIHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001631) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 1631) |
| 363A00000X Physician Assistant (Licence: PA MA052071) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2019-11-26 |