| NPI | 1487973525 |
|---|---|
| Former Name | JENNIFER LEE BERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC1003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1178) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2024-05-31 |