| NPI | 1992042840 |
|---|---|
| Former Name | JENNA ELIZABETH HUMPHREYS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019274) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VA 0110004150) |
| 363AM0700X Physician Assistant Medical (Licence: NY 019274-1) | |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2022-12-12 |