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 |