| NPI | 1902277064 |
|---|---|
| Former Name | JENNIFER LYNN COUILLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 027476) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2025-01-09 |