| NPI | 1295987634 |
|---|---|
| Former Name | JESSICA LEE JUSTICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053625) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053625) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2016-06-09 |