| NPI | 1699198051 |
|---|---|
| Former Name | MARIA SUZANNE JERNIGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54388) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9107750) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2020-01-14 |