| NPI | 1407513369 |
|---|---|
| Former Name | JADE HAWKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007868RX) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25mp00658200) |
| Enumeration Date | 2021-11-26 |
| Last Update Date | 2023-07-20 |