| NPI | 1932428737 |
|---|---|
| Former Name | NIKKI RAE JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50003404) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 20382) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2012-09-07 |