| NPI | 1225772585 |
|---|---|
| Former Name | JESSICA MARIE FERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME172130) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2025-04-28 |