NPI | 1477704559 |
---|---|
Former Name | JENNIFER JOLLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60218759) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 19963) |
363AM0700X Physician Assistant, Medical (Licence: CA 19963) | |
Enumeration Date | 2008-10-07 |
Last Update Date | 2024-10-31 |