| NPI | 1578078622 |
|---|---|
| Former Name | JENNIFER K GOODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12699) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2025-09-04 |