NPI | 1437105442 |
---|---|
Former Name | JENNIFER RENEE DURHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.459) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-05-25 |
Last Update Date | 2023-06-19 |