| NPI | 1982180527 | 
|---|---|
| Former Name | JENNY KRISTINE VALLES | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2153)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56489)  | 
| Enumeration Date | 2018-07-17 | 
| Last Update Date | 2019-10-24 |