| NPI | 1700258415 |
|---|---|
| Former Name | JENNA LYNN EASTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019180) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 19180) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2023-07-17 |