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 |