| NPI | 1639106719 |
|---|---|
| Former Name | JENNIFER LEIGH DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06399) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-06399) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2017-09-25 |