| NPI | 1639139694 |
|---|---|
| Former Name | JENNIFER GRACE WATERWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 3062322) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2007-10-31 |