NPI | 1801140074 |
---|---|
Former Name | JENIFER D HEMSOTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106797) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106797) |
Enumeration Date | 2012-11-09 |
Last Update Date | 2019-05-17 |