NPI | 1962992867 |
---|---|
Former Name | JENNIFER R MANSFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021151) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6560) |
Enumeration Date | 2018-05-16 |
Last Update Date | 2021-04-22 |