| NPI | 1619017167 |
|---|---|
| Former Name | JENNIFER LYNN MILLMUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004370) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004370) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2022-07-22 |