NPI | 1942882972 |
---|---|
Former Name | JENNA ROUX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9116660) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-04-28 |
Last Update Date | 2023-11-08 |