| NPI | 1275764474 |
|---|---|
| Former Name | JESSICA M HAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 1309) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 1309) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2016-12-08 |