NPI | 1760046916 |
---|---|
Former Name | JENNIFER MARIE PISELLI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 7551) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: CA 58101) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-23 |
Last Update Date | 2022-12-19 |