NPI | 1689656910 |
---|---|
Former Name | DARICE R JENKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA 949) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 949) |
Enumeration Date | 2005-11-14 |
Last Update Date | 2015-01-23 |