| NPI | 1306254255 |
|---|---|
| Former Name | JESSICA LEE MCCALLISTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MS 24078) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 24078) |
| 207Q00000X Family Medicine (Licence: MS 24078) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: TX R6698) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2020-07-20 |