NPI | 1699021147 |
---|---|
Former Name | JENNIFER MOLLOY COLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 6481) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 006481) |
Enumeration Date | 2012-08-01 |
Last Update Date | 2018-08-29 |