| NPI | 1093158156 |
|---|---|
| Former Name | JESSICA WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003105) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2016-06-09 |