| NPI | 1598071052 |
|---|---|
| Former Name | JENNIFER LISENKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA3281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60217466) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2022-03-29 |