| NPI | 1578897591 |
|---|---|
| Former Name | JENIVI MARUCUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 21199) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 2293) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2015-05-13 |