| NPI | 1003437633 |
|---|---|
| Former Name | JESSICA MASSIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 105976) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 105976) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |