| NPI | 1679993836 |
|---|---|
| Former Name | JACQUELINE NICOLE DUKES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07236) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 276107) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 14-259) | |
| 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: 86886) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MS PA00327) | |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2020-01-15 |