NPI | 1407163983 |
---|---|
Former Name | JENNIFER ANN SCHUCKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000728) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
Enumeration Date | 2010-09-07 |
Last Update Date | 2017-10-12 |