| NPI | 1982949467 |
|---|---|
| Former Name | JENNIFER L BALENTINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 4918) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00694) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2015-02-20 |