| NPI | 1275823114 |
|---|---|
| Former Name | JESSICA MICHELLE ROBERTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 54061) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2021-03-09 |