| NPI | 1316112444 |
|---|---|
| Former Name | JESSICA B WALLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH 15096) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 15096) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2021-07-12 |