NPI | 1639487762 |
---|---|
Former Name | JESSICA E MCLENNAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NV PA1341) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4694) |
Enumeration Date | 2010-09-23 |
Last Update Date | 2015-03-19 |