NPI | 1205243755 |
---|---|
Former Name | JESSICA PLATT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0003997) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO 0003997) |
Enumeration Date | 2014-07-16 |
Last Update Date | 2021-02-24 |