| NPI | 1033791611 |
|---|---|
| Former Name | ANGELA JESSUP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4789) |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2024-11-15 |