| NPI | 1912443979 |
|---|---|
| Former Name | JENNIFER WEISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP017213) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN601938) |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2017-03-02 |