| NPI | 1497167373 |
|---|---|
| Former Name | JENNIFER TRAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC011) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007029) |
| 363AM0700X Physician Assistant, Medical (Licence: KY TC011) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY TC011) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2025-01-10 |