NPI | 1699265793 |
---|---|
Former Name | JAZMYNE SHIANN SASSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004529) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059902) |
Enumeration Date | 2018-05-14 |
Last Update Date | 2024-10-22 |