| NPI | 1932610714 |
|---|---|
| Former Name | JENNIFER PECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07663) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 0010-07663) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2022-05-17 |