NPI | 1568804920 |
---|---|
Former Name | JENNIFER INGRID GERWICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA163353) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2013-07-25 |
Last Update Date | 2023-09-21 |