| NPI | 1518290139 |
|---|---|
| Former Name | JENNIFER KATHERINE DAVIDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5922) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00224300) |
| 363A00000X Physician Assistant (Licence: PA MA053987) | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2016-10-27 |