| NPI | 1053661348 |
|---|---|
| Former Name | JESSICA LEIGH DOUBERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106699) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2019-03-19 |