NPI | 1689699027 |
---|---|
Other Name | JENN WALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004538) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2917) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2021-07-22 |