| NPI | 1679728315 |
|---|---|
| Former Name | JENNIFER L KOWALCZUK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 002176) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 3903) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2020-08-19 |