NPI | 1780607945 |
---|---|
Former Name | JENNIFER M BISSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 001899) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA052261) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2015-07-17 |