| NPI | 1013144674 |
|---|---|
| Professional Name | JAMIE MICHELLE WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R8646) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2024-11-06 |