NPI | 1154997179 |
---|---|
Former Name | JESSICA JARVEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59580) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-06-01 |
Last Update Date | 2021-06-01 |