NPI | 1356808422 |
---|---|
Former Name | KATIE JENKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00412) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA-00412) |
Enumeration Date | 2019-02-25 |
Last Update Date | 2023-09-20 |