| NPI | 1124557376 |
|---|---|
| Former Name | JESSICA LYNN FALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01115) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2019-12-13 |