NPI | 1689603128 |
---|---|
Former Name | JENNIFER KAY WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21724) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA20140017) |
363A00000X Physician Assistant (Licence: HI AMD-278) | |
Enumeration Date | 2006-06-30 |
Last Update Date | 2023-12-01 |