| NPI | 1912417981 |
|---|---|
| Former Name | JENNA MICHELLE BEDARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021494) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 021494) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2022-09-06 |