NPI | 1568711034 |
---|---|
Former Name | JACQUELINE FREEBERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001057) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2012-08-30 |
Last Update Date | 2018-03-20 |