NPI | 1417519976 |
---|---|
Former Name | JENNI ANNE BLETH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PATEMP) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-07-05 |
Last Update Date | 2020-08-20 |