NPI | 1801405071 |
---|---|
Former Name | JENNY PAULINE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12976388-1206) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-07-23 |
Last Update Date | 2023-08-10 |