| NPI | 1588841621 |
|---|---|
| Former Name | JENNIFER RYAN WAYMIRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2546) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-795) |
| 363A00000X Physician Assistant (Licence: SD 0812) | |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2016-07-18 |