| NPI | 1679662480 |
|---|---|
| Former Name | JEANETTE MARIE POWERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00223600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3500) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 3500) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2009-10-01 |