| NPI | 1104299759 |
|---|---|
| Former Name | JAMIE WEISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 5800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06053) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 5800) | |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2024-09-09 |