| NPI | 1831514132 |
|---|---|
| Former Name | JENNIFER DECKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 18953) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NC 0010-04909) | |
| Enumeration Date | 2014-02-23 |
| Last Update Date | 2019-10-04 |