| NPI | 1104288042 |
|---|---|
| Former Name | JESSICA LYNN OPSAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD52396) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2022-08-02 |