| NPI | 1619952934 | 
|---|---|
| Former Name | JENNIFER MISECHOK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103594) | 
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL PA9103594) | 
| Enumeration Date | 2005-12-09 | 
| Last Update Date | 2025-09-16 |